In a significant legal development, the Delhi High Court has issued a judgment in MACP No. 1033/2018, concerning a dispute between the claimant and the insurance company. The court’s decision, dismissing the appeal by the insurance company, highlights the importance of upholding fair compensation in cases of injury and disability. This ruling will have far-reaching implications for similar legal matters in the future.
Facts
- Nature of injuries suffered by the claimant at the age of 49 was traumatic
- Disability is significant and will impact normal bodily functions for the rest of the claimant’s life
- Compensation for loss of earning capacity needs to be re-worked by assessing notional monthly income at Rs. 10,000/-
- Mental, physical shock, pain and suffering, as well as loss of amenities were awarded a meagre compensation
- Claimant’s disability of 10% for the whole body was uncontroverted and deemed reasonable
- Awarded amount towards loss of income to be enhanced to Rs. 1,20,000/-
- Future earning/functional disability compensation was rightly considered based on claimant’s age and injuries sustained
- Claim petition under Sections 166 and 140 of the M.V. Act allowed, awarding total compensation of Rs. 88,33,363/- for permanent disability of 85%
- Insurer denying liability based on evidence in MACP
- Claimant Aas Mohd., aged 24 at the time of accident, suffered 85% permanent physical impairment in right lower limb
- Disability substantiated by Disability Certificate (Ex. CW-1/1)
- Claimant has not received any compensation till date
Arguments
- Allegations of gross injustice due to misconduct and dilly-dallying by the Insurance Company.
- Misery of the appellant worsened by untraceable driver and registered owner of the offending vehicle.
- Counsel for the claimant referenced various legal decisions to support their position.
- Fraud vitiates everything, and since the offending vehicle was not insured for third-party risks, no liability to pay compensation can be fastened upon the Insurance Company.
- The Insurance Company had taken a specific plea in an earlier claim petition that the policy of insurance was being verified, and evidence was led on the said aspect in the third claim petition.
Analysis
- The appellant/insurance company cannot be allowed to take contradictory stands regarding the genuineness of the cover note/policy of insurance.
- The issue of validity of the policy of insurance was never raised in the earlier MACPs.
- The findings in MACP Nos. 137/2016 and 135/2016, holding the insurance company liable, constitute issue estoppel.
- The testimony of witnesses from the insurance company did not convincingly prove the cover note was forged.
- The appellant’s plea challenging the compensation amount was deemed unsustainable.
- The compensation towards loss of future earning or functional disability needs reassessment based on the claimant’s notional income.
- The genuineness of the cover note was questioned based on errors and inconsistencies in the document.
- The insurance company failed to provide concrete evidence that the cover note/policy was fabricated.
- The Kerala High Court’s decision in Devi T.V. v. Jamsheer P. & Ors. involved two claimants injured in an auto-rickshaw, with different outcomes in their compensation claims.
- A mixed question of law and fact decided in a prior proceeding between the same parties cannot be re-examined in a subsequent proceeding between the same parties.
- In cases involving the interpretation of a statute, a prior decision on a question of law will be binding in a subsequent proceeding between the same parties with the same cause of action.
- The Supreme Court’s ruling in Mathura Prasad Bajoo Jaiswal v. Dossbai N.B. Jeejeebhoy emphasized that the correctness of the earlier judgment is not relevant in determining the application of the rule of res judicata.
- Evidence is inconclusive regarding engagement of nursing assistant or attendant for the appellant
- It is not unlikely that assistance would have been needed during confinement
- Court rules that the judgment in MACP No. 136/2016 cannot stand
- Appellant/insurance company must fulfill financial liability for compensation
Decision
- MAC APP No 1033/2018 filed by the insurance company dismissed
- Compensation amount to be deposited with the Tribunal within four weeks
- Compensation for nursing/attendant enhanced to Rs. 1,00,000/-
- MAC APP No 306/2019 filed by the claimant-injured allowed with enhanced compensation towards future medical treatment
- Detailed breakdown of compensation awarded for various heads like medical treatment, future expenses, loss of income, pain and suffering, etc.
- Penal interest of 12% per annum applicable if compensation not deposited within four weeks
Case Title: SAFEEYA Vs. FUTURE GENERALI INDIA INSURANCE COMPANY LTD & ORS (2024:DHC:4014)
Case Number: MAC.APP.-306/2019
